Poxvirus and Rabies Branch, Division of High-Consequence Pathogens and Pathology, National Center of Emerging and Zoonotic Infectious Diseases, United States Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America.
ORISE Fellow, United States Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America.
PLoS One. 2021 Jun 2;16(6):e0251702. doi: 10.1371/journal.pone.0251702. eCollection 2021.
Rabies is a viral disease of animals and people causing fatal encephalomyelitis if left untreated. Although effective pre- and post-exposure vaccines exist, they are not widely available in many endemic countries within Africa. Since many individuals in these countries remain at risk of infection, post-exposure healthcare-seeking behaviors are crucial in preventing infection and warrant examination.
A rabies knowledge, attitudes, and practices survey was conducted at 24 geographically diverse sites in Uganda during 2013 to capture information on knowledge concerning the disease, response to potential exposure events, and vaccination practices. Characteristics of the surveyed population and of the canine-bite victim sub-population were described. Post-exposure healthcare-seeking behaviors of canine-bite victims were examined and compared to the related healthcare-seeking attitudes of non-bite victim respondents. Wealth scores were calculated for each household, rabies knowledge was scored for each non-bitten survey respondent, and rabies exposure risk was scored for each bite victim. Logistic regression was used to determine the independent associations between different variables and healthcare-seeking behaviors among canine-bite victims as well as attitudes of non-bitten study respondents.
A total of 798 households were interviewed, capturing 100 canine-bite victims and a bite incidence of 2.3 per 100 person-years. Over half of bite victims actively sought medical treatment (56%), though very few received rabies post-exposure prophylaxis (3%). Bite victims who did not know or report the closest location where PEP could be received were less likely to seek medical care (p = 0.05). Respondents who did not report having been bitten by a dog with higher knowledge scores were more likely to respond that they would both seek medical care (p = 0.00) and receive PEP (p = 0.06) after a potential rabies exposure event.
There was varying discordance between what respondents who did not report having been bitten by a dog said they would do if bitten by a dog when compared to the behaviors exhibited by canine-bite victims captured in the KAP survey. Bite victims seldom elected to wash their wound or receive PEP. Having lower rabies knowledge was a barrier to theoretically seeking care and receiving PEP among not bitten respondents, indicating a need for effective and robust educational programs in the country.
狂犬病是一种动物和人类的病毒病，如果不治疗，会导致致命的脑脊髓炎。虽然有有效的暴露前和暴露后疫苗，但在非洲的许多流行国家并不广泛使用。由于这些国家的许多人仍然有感染的风险，因此在暴露后寻求医疗保健至关重要，值得研究。
2013 年，在乌干达 24 个地理位置不同的地点进行了狂犬病知识、态度和实践调查，以获取有关疾病知识、对潜在暴露事件的反应以及疫苗接种实践的信息。描述了调查人群和犬咬伤受害者亚人群的特征。检查了犬咬伤受害者的暴露后医疗保健寻求行为，并将其与非咬伤受害者的相关医疗保健寻求态度进行了比较。为每个家庭计算了财富评分，为每个未被咬伤的调查受访者评分了狂犬病知识，并为每个咬伤受害者评分了狂犬病暴露风险。使用逻辑回归来确定不同变量与犬咬伤受害者的医疗保健寻求行为以及非咬伤研究受访者的态度之间的独立关联。
共访谈了 798 户家庭，共捕获 100 名犬咬伤受害者，每 100 人年的咬伤发生率为 2.3 例。超过一半的咬伤受害者主动寻求医疗治疗（56%），但很少有人接受狂犬病暴露后预防（3%）。不知道或报告最近可以接受 PEP 的位置的咬伤受害者不太可能寻求医疗护理（p=0.05）。没有报告被狗咬过的受访者，他们的知识得分较高，他们更有可能在潜在的狂犬病暴露事件后既寻求医疗护理（p=0.00）和接受 PEP（p=0.06）。
与在 KAP 调查中捕获的犬咬伤受害者的行为相比，没有报告被狗咬过的受访者表示如果被狗咬了会怎么做，这两者之间存在不一致。咬伤受害者很少选择清洗伤口或接受 PEP。狂犬病知识较低是未被咬伤的受访者在理论上寻求护理和接受 PEP 的障碍，这表明该国需要有效的、强有力的教育计划。
